Abstract:
BACKGROUND:For female breast cancer (BC) patients undergoing mastectomy, post-mastectomy breast reconstruction (PMBR) confers significant psychosocial benefits and improved cosmetic outcomes. The objective of this study is to explore whether the utilization of PMBR varies by race, marital status, and geographical location of the patient. METHODS:Women ≥18 years old who underwent mastectomy for breast cancer diagnosed between 2000 and 2014 were eligible. Women with inflammatory BC, Stage IV BC diagnoses, and bilateral BC were excluded. Multivariable logistic regression, adjusting for patient and cancer characteristics, were used to assess the association between of race, marital status, and region on immediate PMBR utilization. RESULTS:321,206 women were included and 24% underwent immediate PMBR (<4 months after mastectomy). Compared to white women, black and other non-white women (OR 0.67, 95% CI 0.65, 0.70 and OR 0.52, 95% CI 0.50, 0.53, respectively) were significantly less likely to receive PMBR. Additionally, women who were single (OR 0.72, 95% CI 0.70, 0.75) or no longer married (OR 0.84, 95% CI 0.82, 0.86) were significantly less likely to undergo breast reconstruction, compared to married women. Regional differences were also seen, with women in the Northeast (OR 2.11, 95% CI 2.05,2.17), Midwest (OR 1.53, 95% CI 1.48, 1.58) and South (OR 1.20, 95%CI 1.17, 1.23) all being more likely to undergo breast reconstruction compared to the West. DISCUSSION:Significant variations exist in the utilization of post-mastectomy breast reconstruction across race, marital status or geographical location of the patient. Further research is needed to elucidate these differences and identify areas for intervention to increase awareness, and access to reconstruction for all breast cancer patients.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Nayyar A,Strassle PD,Reddy KG,Jameison DI,Moses CG,Roughton MC,McGuire KP,Gallagher KKdoi
10.1016/j.amjsurg.2019.07.025subject
Has Abstractpub_date
2019-10-01 00:00:00pages
712-715issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(19)30103-5journal_volume
218pub_type
杂志文章abstract::Measurement of arterial and liver tissue oxygen tension (PO2) in animals subjected to hemorrhagic shock demonstrates a significant (p less than 0.001) decrease in tissue PO2 while PaO2 remains essentially unchanged. In fact, marked increase in PaO2 fail to increase tissue PO2 to control levels, demonstrating that the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90020-4
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to describe the admission characteristics of trauma victims that are predictive of the development of delirium during hospitalization. METHODS:In this case-control study, data (demographics, injury type, medical histories, admission laboratory values, medications, and outcomes)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.027
更新日期:2004-03-01 00:00:00
abstract:INTRODUCTION:Assessing outcomes in patients with colon cancer (CC) undergoing surgical intervention is challenging. Frailty has been as established tool for assessing patient outcomes. The aim was of this study was to assess role of frailty in patients with CC. METHODS:National estimates for patients with CC were abst...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.07.006
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.019
更新日期:2019-07-01 00:00:00
abstract::This study prospectively compared the following tests for their accuracy in amputation level selection: transcutaneous oxygen, transcutaneous carbon dioxide, transcutaneous oxygen-to-transcutaneous carbon dioxide, foot-to-chest transcutaneous oxygen, intradermal xenon-133, ankle-brachial index, and absolute popliteal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90174-7
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.012
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Appropriate therapy for women over 70 years of age with breast cancer is currently a highly debated topic. The aim of this study was to determine whether a subset of patients could be identified in which lumpectomy alone, followed by tamoxifen, would offer adequate local, regional, and long-term control of d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00474-8
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:A review of 1993 data on length of stay (LOS) and charges for diagnosis-related group (DRG) 195 (complicated cholecystectomies) showed that Maricopa Medical Center charged more and had longer LOS than all other area hospitals. METHODS:Twenty DRG 195 charts were analyzed for the causes of the inefficiencies....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80035-x
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:This study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care. METHODS:Myocardial tissue pH corrected to 37 degrees C (pH(37C)) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.023
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:General surgery residents are often not present for the critical intraoperative discussion between surgeon and pathologist regarding surgical pathology findings. METHODS:A prospective pilot study analyzed general surgery resident exposure to surgical pathology. Thereafter, an operating room was equipped to ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.09.010
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. METHODS:Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.041
更新日期:2020-11-01 00:00:00
abstract::A significant impairment in the intestinal absorption of D-xylose and vitamin A was observed in the first weeks after preservation and transplantation of the whole small bowel. Functional recovery was only observed in long-term survivors, usually transplanted dogs that lived more than five weeks. There was no impairme...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90297-4
更新日期:1975-02-01 00:00:00
abstract:BACKGROUND:Antibiotic prophylaxis during placement of implanted central venous access ports (CVAP) has not been studied. This retrospective review compared the rate of catheter-related infections (CRIs) with and without perioperative antibiotics. METHODS:This was a single-center study that compared patients treated wi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.023
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Minor burns represent .96% to 1.5% of emergency department visits, yet burn center referral is common. Analysis of the Grady Memorial Hospital Burn Center examined the feasibility and savings if pediatric burns were managed locally with as-needed consultation. METHODS:Prospective data on 219 consecutive adm...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.06.036
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Most thymectomies are performed via sternotomy. Minimally invasive thymectomy (MIT) has been described but its potential benefits and drawbacks remain unclear. METHODS:A retrospective chart review comparing thymectomies performed via sternotomy to MIT at a single institution between 2005 and 2009. RESULTS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.01.001
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Whether or not tumor response to chemotherapy-sensitized radiation therapy (CTRT) for head and neck cancer leads to an improved outcome is unknown. METHODS:Forty patients who received preoperative cisplatin plus simultaneous radiotherapy for operable stage III and IV head and neck cancer were reviewed retro...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00151-7
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Patients with recurrent pelvic malignancy have few treatment options, and surgery is fraught with complications. We sought to characterize the relationship between radiographic pelvic volume and postoperative complications after pelvic salvage surgery. METHODS:A retrospective chart review of all patients un...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.015
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The purpose of this paper is to review the experience of a community surgeon performing laparoscopic antireflux procedures (LAP). The experience has been difficult and at times unsettling, and underscores the need for advanced laparoscopic expertise not normally obtained performing laparoscopic cholecystecto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(97)89608-0
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Lack of exposure to surgery in the preclinical years of medical school contributes to students' negative opinions of the field and to low application rates to categorical surgical programs. METHODS:Forty preclinical medical students attended a series of 16 seminars and practice sessions covering the gamut o...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.12.038
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcomes for laparoscopic Roux-en-Y gastric bypass in a newly developed bariatric surgery program. METHODS:A prospective analysis of the initial 100 patients who underwent laparoscopic Roux-en-Y gastric bypass at a community based teaching hospital between December 2000 and October 2001 was p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01098-x
更新日期:2002-12-01 00:00:00
abstract::In an effort to assess the impact of enhanced macrophage function in acute pancreatitis, mice were subjected to a choline-deficient diet supplemented by ethionine to induce necrotizing pancreatitis. Treatment with the macrophage stimulant glucan resulted in improved survival rates (58 percent versus 14 percent) and ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90197-8
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Hepatic resection is main approach to treatment of hepatolithiasis, but the long-term follow-up results of hepatic resection for hepatolithiasis are rarely reported. METHODS:A retrospective study was conducted of 87 patients with hepatolithiasis who underwent hepatic resection. RESULTS:The final stone clea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.08.020
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:The role of advanced life support (ALS) versus basic life support (BLS) in blunt trauma is controversial. Previous studies have shown no mortality benefit with ALS for penetrating trauma but the blunt population has mostly remained unaddressed. METHODS:A retrospective cohort study was conducted at a Level...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.01.012
更新日期:2020-09-01 00:00:00
abstract::Limb ischemia due to blunt trauma, dissecting hematoma, and cardiac dysfunction jeopardizes limbs and lives more than is generally appreciated. Delay in diagnosis after blunt trauma led to major amputation in 21 percent of our patients. Current principles avoid those hazards. Five patients presented with acute limb is...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90513-x
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Several nationwide reports show lower female participation in colon cancer screening. We therefore assessed for outcome differences in women of screening age presenting for surgical treatment of colon cancer patients. METHODS:All patients over 50 years undergoing surgery for first-onset colon cancer at Mass...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.09.033
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2004.08.066
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Obturator hernia is a relatively rare pelvic hernia and usually occurs in elderly, thin, multiparous women. Because symptoms are nonspecific, the diagnosis is often delayed until laparotomy is performed form to treat bowel obstruction. METHODS:Forty-three patients with obturator hernia undergoing surgery at...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.041
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:A prospective trial was undertaken to investigate the advantages and disadvantages of stapled skin closure versus conventional nylon sutures in head and neck surgery. PATIENTS AND METHODS:The study included 20 consecutive patients who underwent extensive surgery in which their skin was closed with staples. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80327-4
更新日期:1995-11-01 00:00:00
abstract::The lower esophageal high pressure zone (HPZ) was characterized manometrically and reflux status determined in eight male rhesus monkeys. The studies were repeated six weeks and six months after 50 per cent distal small bowel resection. At the same time fasting serum gastrin and gastric inhibitory polypeptide values w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90002-2
更新日期:1977-05-01 00:00:00
abstract::Information illustrating the benefits of fracture stabilization after multiple trauma has been gathering for almost a century. At the turn of the last century, the introduction of the Thomas splint clearly demonstrated the importance of skeletal stabilization in the management of these patients. The introduction of st...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/s0002-9610(02)00865-6
更新日期:2002-06-01 00:00:00